Enhancing Telehealth Use To Reduce No-Shows in a Rural Arizona Outpatient Clinic

Abstract

Purpose: This quality improvement (QI) project evaluated provider perceptions of telemedicine as a strategy to reduce no-show rates at a rural Federally Qualified Health Center (FQHC). The project examined whether a brief educational session could improve provider understanding and willingness to use telehealth. Background: Patients missing appointments is a common problem in rural clinics and remains a persistent issue, often leading to delayed treatment, poor chronic disease management, and increased healthcare costs. Telemedicine offers a way to ease access barriers such as transportation and scheduling conflicts (Adepoju et al., 2022). However, provider buy-in is essential for successful adoption. Understanding how clinicians view telemedicine, including its usability, benefits, and limitations, is key to sustaining virtual care models. Methods: A pre- and post-survey design was used to assess changes in provider perceptions using a slightly modified version of the Telehealth Usability Questionnaire (TUQ). Providers completed the survey before and after a live virtual educational session focused on telemedicine's benefits in rural primary care. The session was delivered during a regular provider meeting. Survey data included Likert-scale items and open-ended responses to evaluate changes in knowledge, attitudes, and intent to use telehealth. Results were analyzed to determine whether the intervention improved confidence and interest in using telemedicine to reduce no-shows. Results: Four primary care providers completed the pre- and post-intervention surveys. Pre-intervention results demonstrated positive baseline perceptions of telehealth usability, workflow compatibility, and willingness to adopt telehealth, with 75% of providers at this site agreeing or strongly agreeing across these domains. Following the educational intervention, ease of use and provider confidence improved, while workflow compatibility and willingness to adopt remained stable. Qualitative feedback highlighted the need for additional training on billing and documentation and strategies to address patient technology barriers. Conclusions: A brief focused educational session increased provider confidence and perceived ease of use of telemedicine in a rural FQHC, while reinforcing already positive attitudes toward adopting telemedicine. These findings suggest that provider-focused education may be an effective strategy to support telehealth utilization and reduce no-show rates in rural primary care. Ongoing training and resources addressing billing, documentation, and patient technology barriers may further enhance adoption and sustainability.